Dr. Desiree Tillman, D.D.S.
Dentist in Los Angeles, CA. Individual provider (NPI-1).
NPI number1730383100
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1730383100
- Entity type
- Individual (NPI-1)
- Name
- Dr. Desiree Tillman
- Credential
- D.D.S.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 12, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 30655 | CA | Yes |
Practice location
3756 Santa Rosalia DrSuite 204
Los Angeles, CA 90008-3606
Phone 323-293-7225
Mailing address
3756 Santa Rosalia DrSuite 204
Los Angeles, CA 90008-3606
Phone 323-293-7225
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